Certified Hemodialysis Technologist/Technician Exam Medications and Pharmacology in Dialysis 1 — Questions and Answers
Question 1: Which class of medications is most commonly used to treat anemia in dialysis patients?
- Iron supplements only
- Erythropoiesis-stimulating agents (ESAs) (Correct answer)
- Vitamin B12 injections
- Granulocyte colony-stimulating factors
Correct answer: Erythropoiesis-stimulating agents (ESAs)
Erythropoiesis-stimulating agents (ESAs) such as epoetin alfa and darbepoetin stimulate red blood cell production in anemic dialysis patients.
Question 2: What is the target hemoglobin range recommended by KDIGO guidelines for dialysis patients receiving ESA therapy?
- 8–9 g/dL
- 10–11.5 g/dL (Correct answer)
- 12–13 g/dL
- 13–15 g/dL
Correct answer: 10–11.5 g/dL
KDIGO guidelines recommend maintaining hemoglobin between 10–11.5 g/dL for dialysis patients to reduce transfusion risk without increasing cardiovascular events.
Question 3: IV iron administration during hemodialysis is timed to coincide with:
- The first 30 minutes of treatment (Correct answer)
- The last hour of treatment only
- Any time during dialysis is equally appropriate
- After the blood pump is stopped
Correct answer: The first 30 minutes of treatment
IV iron is typically given in the first 30 minutes of dialysis to allow maximum monitoring time for infusion reactions.
Question 4: Which phosphate binder is calcium-based and most commonly used in dialysis patients?
- Sevelamer
- Lanthanum carbonate
- Calcium carbonate (Correct answer)
- Aluminum hydroxide
Correct answer: Calcium carbonate
Calcium carbonate is a widely used, calcium-based phosphate binder that binds dietary phosphate in the GI tract.
Question 5: Why is aluminum hydroxide generally avoided as a long-term phosphate binder in dialysis patients?
- It causes hyperphosphatemia
- It causes aluminum toxicity leading to dementia and bone disease (Correct answer)
- It is too expensive
- It is rapidly dialyzed off
Correct answer: It causes aluminum toxicity leading to dementia and bone disease
Chronic aluminum hydroxide use leads to aluminum accumulation causing dialysis dementia and adynamic bone disease.
Question 6: Which anticoagulant is most frequently used during hemodialysis to prevent clotting in the extracorporeal circuit?
- Warfarin
- Low-molecular-weight heparin
- Unfractionated heparin (Correct answer)
- Bivalirudin
Correct answer: Unfractionated heparin
Unfractionated heparin is the standard anticoagulant used during hemodialysis due to its rapid onset, short half-life, and reversibility with protamine.
Certified Hemodialysis Technologist/Technician Exam Medications and Pharmacology in Dialysis 1
Which class of medications is most commonly used to treat anemia in dialysis patients?